By MICHELLE HAACKE

michelle.haacke@albertleatribune.com

It seems like you hear more and more in the media about depression in adolescents every day.

However, the reality is that the number of adolescents diagnosed with depression remains about the same as it has been over the past decade.

“The trend has maintained about the same rates, but the detection has gotten better,” said Dr. Kathryn Schak. “That’s likely due to increased awareness and early identification.”

Schak is a child and adolescent psychiatrist at the Austin Medical Center, part of Mayo Health System. She treats children and adolescents from across the south central region of the state.

According to Schak, about 5 percent of kids under the age of 18, from the general population, will be diagnosed with clinical depression. When she talks about adolescents, she’s talking about children from tweens to teens: ages 12 to 18.

Although Schak has seen cases where children as young as 6 or 7 years old have experienced symptoms of depression, she said those cases are very rare and in those situations, the behavior is secondary to a bigger issue, such as neglect or trauma that the youngster has likely experienced.

She said depression in adolescents is similar to that of adults.

Biological factors may make a teen or pre-teen more predisposed to showing signs of depression. Not only a predisposition to depression, but an adolescent’s overall personality may play into it. Hormones may also contribute to depressive symptoms, along with hormonal changes a child goes through into puberty.

Changes in social circumstances and changes in the environment are other reasons reported in adolescents who are showing signs of depression. In teens, dating, friendships and relationships can also be key.

More than anything, however, Schak said the symptoms of childhood depression are caused by many factors.

“You generally can’t identify one simple cause,” Schak said. “The loss of a significant person in a child’s life may be one example.”

She said symptoms are broad, but may include social withdrawal, more disruptive behavior, more emotional or moody behavior and disrupted sleep patterns.

“The biggest difference between adults and children is crabbiness,” said Schak.

She said irritability is a key symptom in identifying signs of depression in adolescents. “They don’t necessarily have to say they are sad or depressed, but they may have a very bad temper, can be irritable, and they’re basically very difficult for adults to be around.”

Other symptoms Schak advises parents to look for is decreased interest in activities, changes in appetite and having a tough time sleeping — or sleeping too much. Feelings of physically slowing down and expressing guilt over things that may have happened weeks ago are other things parents can look for.

Sometimes, adolescents will show signs often associated with attention deficit hyperactivity disorder, such as anxiousness or appearing keyed up, along with difficulties in concentration.

“It’s not uncommon for children showing possible signs of ADHD to be identified as depressed,” Schak said.

Schak said children are generally referred to her through a pediatrician. Treatment will depend on how long the symptoms have been going on, the child’s age, and how impairing the symptoms are — meaning how much the symptoms are getting in the way of the teen or pre-teen living a “normal” life.

“If the child can’t get out of bed and is tearful, or has a heightened anxiety about going to school, then that’s a significant impairment,” Schak said.

Talk therapy or psychotherapy is generally first recommendation by Schak, with medications used in more severe cases or when psychotherapy was not found to be effective.

The most dangerous outcome of depression in adolescents is suicide. Schak said it’s crucial that parents identify suicidal behavior and thoughts, and get the child help in those situations.

“We’ve got to make sure we’re communicating with our kids,” she said.

Things to look for in this situation include adolescents displaying morbid thoughts, talking about topics related to death and self injurious behavior — or cutting.

“Monitoring any signs and changes from that baseline is important,” she said.

Schak often refers parents to the website www.aacap.org for more information and guidelines with depression in adolescents.